Fixed combination of amlodipine and lisinopril effectiveness in hypertensive smokers

Objective. To conduct a comparative analysis of blood pressure (BP) profile characteristics in middle-aged (45–65 years) patients with stage 1–2 hypertension not associated with comorbid cardiovascular disease depending on smoking status; to estimate the influence of fixed combination of amlodipine and lisinopril (FC A/L) use on these characteristics. Materials and methods. At the first stage of the study 60 untreated patients (31 men, 29 women, mean age 53.6±0.8 years) with stage 1–2 hypertension were divided in two groups according to smoking status. The smoking group included 11 men and 11 women with mean age 53.4±1.2 years, non-smoking group – 20 men and 18 women with mean age 53.7±1.0 years. Ambulatory blood pressure monitoring (ABPM) (monitor MDP-НС-02с, DMS) and BP measurement based on Korotkov sound technique as well as transthoracic echocardiography were performed in all patients. At the second stage a subgroup of 30 untreated patients (16 men, mean age 52.7±1.11 years, 40% smokers [12 patients]) was formed. Patients received FC A/L (Ekvator®) with starting dose 5 mg/10 mg titrated every 14 days until target BP lower than 140/90 mm Hg was reached. The therapy was continued for 12 weeks, after that ABPM was performed again. Results. In smokers and non-smokers with hypertension no significant differences in BP levels in office BP measurement and ABPM were observed. At the second stage all 30 patients receiving FC A/L reached target office BP levels. In subgroups of smokers and non-smokers with hypertension significant office systolic BP (p<0.001 in both groups), diastolic BP (p<0.001 in both groups), and pulse BP (p<0.05 and р<0.001, respectively) reduction was observed on FC A/L treatment. There were no significant differences in office BP dynamics between subgroups. At the end of follow-up a significant decrease of systolic BP within 24 hours (p<0.001 in both groups), diastolic BP within 24 hours (p<0.001 in both groups), and pulse BP within 24 hours (р<0.01 and p<0.001, respectively) was observed. A significant decrease of day systolic and diastolic BP (p<0.001 for both parameters in both groups) and also pulse BP (p<0.01 and p<0.001, respectively) was observed in both groups of patients. A significant decrease of night systolic BP (p<0.001 in both groups), diastolic BP (p<0.01 and p<0.001, respectively), and pulse BP (p<0.01 in both groups) was observed in smokers and non-smokers. There were no significant differences between the groups in systolic, diastolic, and pulse BP dynamics according to ABPM. There was a significant reduction in systolic day BP variability (p<0.01 and p<0.05, respectively) and diastolic night BP variability (p<0.001 и p<0.05, respectively) in smokers and non-smokers on FC A/L therapy. In hypertensive smokers a significant reduction of diastolic day BP variability was also observed (p<0.05). Conclusions. Smoking does not influence a 24 hours BP profile in patients aged 45–65 years with stage 1-2 hypertension. The FC A/L use in these patients has antihypertensive effect regardless of smoking status

Markers of early target-organ brain damage in essential arterial hypertension: the search continues. Possibilities of diffusion tensor magnetic resonance imaging

The article touches upon the issue of brain as an end-organ target of essential arterial hypertension (AH). The article gives current information about the possibilities and potential clinical application of diffusion-tensor magnetic resonance imaging for the earliest assessment of white matter damage in patients with essential AH. Dataare presented upon the reduction of fractional anisotropy in hypertensive patients and its correlation with blood pressure level

Nephroprotective in patients with metabolic syndrome: approaches to the appointment of antihypertensive drugs

In the article shows the questions of prevalence, diagnosis and prognostic significance of renal damage in metabolic syndrome. Discusses the pathogenetic mechanisms of development and progression of chronic kidney disease in individuals with obesity. Approaches to selection of antihypertensive drugs, advantages and limitations of the major classes of antihypertensive drugs in the treatment of metabolic syndrome, arterial hypertension combined with renal disease

The efficacy and safety of torasemid in the treatment of arterial hypertension in different clinical situations

The article considers issues of efficiency and safety of the use of torasemid, a loop diuretic, with the additional property of antagonist of the mineralocorticoid receptor in the treatment of arterial hypertension in different groups of patients

Vascular stiffness in patients with arterial hypertension: possible antihypertensive therapy

The article discusses the factors that increase the arterial stiffness: the blood pressure, atherosclerosis, smoking, diabetes, age. Given evidence that pulse wave velocity and a number of other indicators that reflect the state of the vascular wall, are markers for increased risk of cardiovascular complications and mortality. The influence of antihypertensive drugs of different groups on the stiffness of the vascular wall, with particular attention paid to the effects of drugs from group of diuretics. We discuss possible mechanisms of the influence of indapamide retard on the elastic properties of vessels. It is emphasized that the influence on the stiffness of the arteries of different antigipertenzivny medicines, even belong to the same class, is different, due to differences in pharmacokinetic properties

"Workplace hypertension": focus on emotional and personality traits in patients

This article discusses the literature data on the prevalence, diagnosis and mechanisms of development of “workplace hypertension”. The paper contains the results of our own studies indicating that patients with “workplace hypertension” are suffering from different emotional and personality traits, such as high emotionality, suppression of emotional expression, and use of inefficient emotion regulation strategies, significant perfectionism associated with socially prescribed perfectionism

Dihydropyridine calcium antagonists: conscious choice

This article contains information concerning the aspects of pharmacokinetics and pharmacodynamics of dihydropyridine calcium antagonists. The authors have discussed the evidence-based amlodipine treatment of arterial hypertension, ischemic heart disease and chronic heart failure. The authors present the comparison of the efficacy, safety and application characteristics of the different dihydropyridine calcium antagonists that can be used in specific clinical cases

Милдронат. Синдром хронической усталости

Chronic fatigue syndrome (CFS) is a state of constant, impairing quality of life, fatigue, lasting more than 6 months, inexplicable by any of coexisting patients pathological conditions. The prevalence of CFS in the world is approximately 2 % of the population (120-140 mln inhabitants of Earth). The etiology of CFS is unknown. Several theories of development of CFS have been proposed (immune, infectious, endocrine, metabolic, neurological, psychiatric), however, none of them fully explains the clinical manifestations of CFS. There is no specific treatment for this condition. This article presents the clinical case of a patient B 45 years old with CFS, who received treatment with regular physical exercises, diet (limiting consumption of coffee and caffeine-containing products, alcohol, salt intake to less than 5 g per day, an increase in the consumption of plant foods and products containing potassium, calcium, magnesium), as well as intake of Mildronat, a positive dynamics was observed, manifested by an increase in productivity at work, decrease in fatigue, a decrease in the daily variability of blood pressure and a decrease in heart rate at rest.Синдром хронической усталости (СХУ) - это состояние постоянной, ухудшающей качество жизни, усталости, длящееся более 6 месяцев, необъяснимое имеющимися у пациента патологическими состояниями. Распространенность СХУ в мире составляет приблизительно 2 % населения (120-140 млн человек). Этиология СХУ неизвестна. Выдвинуто несколько теорий развития СХУ (иммунная, инфекционная, эндокринная, обменная, неврологическая, психиатрическая), однако ни одна из них не дает объяснения клиническим проявлениям СХУ в полной мере. Специфического лечения этого состояния нет. В данной статье представлен клинический случай пациентки В., 45 лет, с СХУ, у которой на фоне регулярных занятий физической культурой с врачом ЛФК, консультаций по вопросам гигиены сна, диетологических интервенций (ограничение употребления кофе и кофеинсодержащих продуктов, алкоголя, соли [менее 5 г в сутки]; увеличение потребления растительной пищи и продуктов, содержащих калий, кальций, магний), а также медикаментозного лечения препаратом Милдронат наблюдалась положительная динамика, проявляющаяся повышением работоспособности, уменьшением чувства усталости, снижением суточной вариабельности АД и уменьшением ЧСС в покое

Herpangina. Clinical case

Enterovirus infections are a group of acute infectious diseases caused by enteroviruses (including Coxsackie A and B viruses, ECHO viruses ), which clinically present symptoms of damage to the central nervous system, cardiovascular system, gastrointestinal tract, muscular system, mucous membranes and skin, fever. This article presents a clinical case of patient L., 12 years old, who admitted to an otorhinolaryngologist with clinical manifestations of herpangina. The diagnosis was confirmed by PCR. The patient was prescribed, adequate rehydration, diet with the exclusion of salty, spicy and fried foods, restriction of physical activity, exclusion of thermal procedures, Benzydamine Spray (Oralsept) 0.255 mg/dose, 6 doses 3 times/day, topically, on demand and inosine pranobex (Groprinosin) in a daily dose of 50 mg/kg of body weight: 1 tablet 500 mg 4 times a day for 7 days (at the rate of 1 tablet of 500 mg per 10 kg of body weight; for a patient weighing 41 kg — 4 tablets per day). On the 10th day from the onset of the disease, the docter noted a complete regression of clinical symptoms and the patient was discharged with recovery. © A.P. PEREVERZEV, A.S. PEREVERZEVA, V.I. POPADYUK, O.D. OSTROUMOVA

КОМБИНАЦИЯ КОМПОНЕНТОВ ДЛЯ ПОДДЕРЖАНИЯ ИЛИ УЛУЧШЕНИЯ ФУНКЦИОНАЛЬНОГО СТАТУСА У ПАЦИЕНТОВ ПОЖИЛОГО И СТАРЧЕСКОГО ВОЗРАСТА (ANTI-AGE MEDICINE)

Aging is a process of changing living systems in time, causing disturbances in their structure and functions, which lead to decrease in the reserve capacity of most systems of the human body and is accompanied by related comorbidities, as well as an increase in mortality. The modern theory of pathogenesis of aging is called inlammaging, originated from the English inflammation - inflammation and aging - aseptic, sterile, mild inflammation that is responsible for processes of aging and age-related comorbidities including osteoarthritis, one of the most common diseases among elderly patients. Drugs, which help to slow down the progression of inflammation and used in combination with non-pharmacological methods of prevention of this condition belong to the group of so-called anti-age medicine, as they reduce the severity of age-related problems and syndromes, as well as contribute to the maintenance/improvement of the functional status of the patient. One of these drugs is Alflutop, which contains a combination of components that have an anti-inflammatory effect on osteoarthritis and inflammaging. This article highlights pathogenetic mechanisms of inflammation caused by aging and osteoarthritis, as well as the points of application of the pharmacological action of the components of the drug Alflutop.Биологическое старение - процесс изменения живых систем во времени, вызывающий нарушения в их структуре и функции, которые приводят к уменьшению резервных возможностей большинства систем организма человека и сопровождаются формированием сцепленных с ним болезней, а также увеличением смертности. Наиболее состоятельной в настоящий момент принята теория так называемого инфламэйджинга (inflammaging от англ. inflammation - воспаление и aging - старение), согласно которой во время старения развивается хроническое асептическое слабовыражен-ное воспаление, которое лежит в основе патогенеза возраст-ассоциированных синдромов и заболеваний, в том числе остеоартрита - одного из наиболее распространенных и актуальных заболеваний среди пожилых пациентов. Лекарственные препараты, которые способствуют замедлению прогрессирования инфламэйджинга и применяются в дополнение к нефармакологическим методам профилактики данного состояния, относятся к группе так называемых антивозрастных, или anti-age-препаратов (anti-age medicine), так как способствуют уменьшению выраженности воз-раст-ассоциированных проблем и синдромов, а также поддержанию/улучшению функционального статуса пациента с сохранением максимально возможной его независимости от помощи посторонних лиц. Одним из таких лекарственных препаратов является Алфлутоп, содержащий комбинацию компонентов, оказывающих противовоспалительное действие как на патологические процессы остеоартрита, так и инфламэйджинга. В данной статье представлен обзор патогенетических механизмов, характерных для воспалительной реакции при старении и остеоартрите, а также точки приложения фармакологического действия компонентов препарата Алфлутоп